Provider Demographics
NPI:1154933133
Name:PARTRIDGE, MADISON ANNE
Entity type:Individual
Prefix:DR
First Name:MADISON
Middle Name:ANNE
Last Name:PARTRIDGE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1775 COLUMBIA PARK TRL # D-135
Mailing Address - Street 2:
Mailing Address - City:RICHLAND
Mailing Address - State:WA
Mailing Address - Zip Code:99352-4822
Mailing Address - Country:US
Mailing Address - Phone:563-343-8792
Mailing Address - Fax:
Practice Address - Street 1:3215 HARRISON AVE NW
Practice Address - Street 2:
Practice Address - City:OLYMPIA
Practice Address - State:WA
Practice Address - Zip Code:98502-8704
Practice Address - Country:US
Practice Address - Phone:609-563-8273
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-20
Last Update Date:2021-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAP461098155183500000X
WAPH61083277183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist